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  1. Article ; Online: 2020 Updated Asthma Guidelines: Intermittent inhaled corticosteroids and long-acting muscarinic antagonists for asthma-the latest NAEPP guidelines are SMART!

    Wechsler, Michael E

    The Journal of allergy and clinical immunology

    2021  Volume 147, Issue 5, Page(s) 1640–1642

    Language English
    Publishing date 2021-03-17
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2021.03.012
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  2. Article ; Online: Eosinophilic respiratory disorders and the impact of biologics.

    Bernstein, Joshua S / Wechsler, Michael E

    Current opinion in pulmonary medicine

    2023  Volume 29, Issue 3, Page(s) 202–208

    Abstract: ... Recent findings: Key immunologic pathways affecting Type 2 inflammation through immunoglobulin E (IgE ...

    Abstract Purpose of review: Eosinophils are involved in combating parasitic, bacterial, viral infections as well as certain malignancies. However, they are also implicated in an array of upper and lower respiratory disease states. Through a deeper understanding of disease pathogenesis, targeted biologic therapies have revolutionized glucocorticoid sparing treatment of eosinophilic respiratory diseases. This review will focus on the impact of novel biologics on the management of asthma, eosinophilic granulomatosis with polyangiitis, allergic bronchopulmonary aspergillosis (ABPA), hypereosinophilic syndrome (HES) and chronic rhinosinusitis with nasal polyposis (CRSwNP).
    Recent findings: Key immunologic pathways affecting Type 2 inflammation through immunoglobulin E (IgE), interleukin (IL-4), IL-5, IL-13, and upstream alarmins such as thymic stromal lymphopoietin (TSLP), have led to novel drug developments. We explore the mechanism of action for Omalizumab, Mepolizumab, Benralizumab, Reslizumab, Dupilumab, and Tezepelumab, their respective Food and Drug Administration (FDA) indications, and biomarkers affecting treatment decisions. We also highlight investigational therapeutics that are likely to impact the future management of eosinophilic respiratory diseases.
    Summary: Insight into the biology of eosinophilic respiratory diseases has been critical for understanding disease pathogenesis and has contributed to the development of effective eosinophil-targeted biologic interventions.
    MeSH term(s) Humans ; Churg-Strauss Syndrome/drug therapy ; Granulomatosis with Polyangiitis/drug therapy ; Asthma/drug therapy ; Omalizumab/therapeutic use ; Biological Products/therapeutic use
    Chemical Substances Omalizumab (2P471X1Z11) ; Biological Products
    Language English
    Publishing date 2023-03-03
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1285505-4
    ISSN 1531-6971 ; 1070-5287 ; 1078-1641
    ISSN (online) 1531-6971
    ISSN 1070-5287 ; 1078-1641
    DOI 10.1097/MCP.0000000000000951
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Open-inhaler versus single-inhaler triple therapy (long-acting muscarinic antagonist, inhaled corticosteroid, and long-acting β

    Wechsler, Michael E / Oppenheimer, John J

    The Journal of asthma : official journal of the Association for the Care of Asthma

    2023  Volume 60, Issue 9, Page(s) 1633–1645

    Abstract: Objective: To review the evidence for the use of open-inhaler (inhaled corticosteroid [ICS] plus long-acting β: Data sources: Original research articles were identified from PubMed using the search term "triple therapy asthma." Information was also ... ...

    Abstract Objective: To review the evidence for the use of open-inhaler (inhaled corticosteroid [ICS] plus long-acting β
    Data sources: Original research articles were identified from PubMed using the search term "triple therapy asthma." Information was also retrieved from the ClinicalTrials.gov website.
    Study selections: Articles detailing the use of add-on LAMA to ICS plus LABA (open-inhaler triple therapy), and closed triple therapy compared with ICS plus LABA dual therapy, addressing patient symptoms, exacerbations, and health-related quality of life.
    Results: Open-inhaler triple therapy was associated with a significantly reduced incidence of hospitalizations and emergency department visits and a decrease in ICS dose, oral corticosteroids use, and antibiotics use. Exacerbations and acute respiratory events were also reduced. Single-inhaler triple therapy showed a greater improvement in lung function, asthma control, and health status and was noninferior to open-inhaler triple therapy for Asthma Quality of Life Questionnaire scores. Single-inhaler triple therapy may also lead to improved therapy adherence.
    Conclusion: Add-on LAMA to ICS plus LABA (open- or single-inhaler triple therapy) improves the response in patients who remain symptomatic and provides a reasonable alternative to ICS dose escalation in treatment-refractory patients.
    MeSH term(s) Humans ; Asthma/drug therapy ; Asthma/chemically induced ; Muscarinic Antagonists/therapeutic use ; Muscarinic Antagonists/adverse effects ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Quality of Life ; Administration, Inhalation ; Adrenergic beta-2 Receptor Agonists ; Nebulizers and Vaporizers ; Drug Therapy, Combination ; Adrenal Cortex Hormones
    Chemical Substances Muscarinic Antagonists ; Adrenergic beta-2 Receptor Agonists ; Adrenal Cortex Hormones
    Language English
    Publishing date 2023-04-23
    Publishing country England
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603816-5
    ISSN 1532-4303 ; 0277-0903
    ISSN (online) 1532-4303
    ISSN 0277-0903
    DOI 10.1080/02770903.2023.2188556
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: BT or MAb: That is the question!

    Wechsler, Michael E

    Respirology (Carlton, Vic.)

    2020  Volume 25, Issue 12, Page(s) 1222

    MeSH term(s) Antibodies, Monoclonal, Humanized ; Asthma ; Bronchial Thermoplasty ; Humans
    Chemical Substances Antibodies, Monoclonal, Humanized ; mepolizumab (90Z2UF0E52)
    Language English
    Publishing date 2020-10-11
    Publishing country Australia
    Document type Editorial ; Comment
    ZDB-ID 1435849-9
    ISSN 1440-1843 ; 1323-7799
    ISSN (online) 1440-1843
    ISSN 1323-7799
    DOI 10.1111/resp.13958
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  5. Article ; Online: Letter from the USA.

    Wechsler, Michael E

    Respirology (Carlton, Vic.)

    2019  Volume 25, Issue 2, Page(s) 221–222

    Language English
    Publishing date 2019-12-17
    Publishing country Australia
    Document type Letter
    ZDB-ID 1435849-9
    ISSN 1440-1843 ; 1323-7799
    ISSN (online) 1440-1843
    ISSN 1323-7799
    DOI 10.1111/resp.13757
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  6. Article ; Online: Biologic medications in asthma: What have we learned from long-term studies?

    Chupp, Geoffrey / Wechsler, Michael E

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

    2022  Volume 129, Issue 2, Page(s) 138–139

    MeSH term(s) Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Biological Products/therapeutic use ; Humans ; Longitudinal Studies
    Chemical Substances Anti-Asthmatic Agents ; Biological Products
    Language English
    Publishing date 2022-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1228189-x
    ISSN 1534-4436 ; 0003-4738 ; 1081-1206
    ISSN (online) 1534-4436
    ISSN 0003-4738 ; 1081-1206
    DOI 10.1016/j.anai.2022.05.023
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  7. Article ; Online: A rational approach to compare and select biologic therapeutics in asthma.

    Wang, Eileen / Wechsler, Michael E

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

    2022  Volume 128, Issue 4, Page(s) 379–389

    Abstract: ... E, (2) anti-interleukin (IL)-5 or IL-5 receptor, and (3) anti-IL-4 receptor α. There are also ...

    Abstract Objective: To review key literature on asthma biologic therapeutics-currently available and under investigation-to inform a rational approach to select biologics for the management of people with severe asthma by precision medicine.
    Data sources: We used the PubMed database to review literature on biologic therapeutics in asthma.
    Study selections: We included published randomized control trials and real-world studies on biologic therapeutics, available in English, through September 2021.
    Results: Increased understanding of asthma endotypes and the roles of various inflammatory mechanisms has led to therapeutic agents that inhibit specific cytokines or immune pathways. Currently available biologic therapeutics target type 2-high asthma. Grouped by mechanisms of action, there are the following 3 types: (1) anti-immunoglobulin E, (2) anti-interleukin (IL)-5 or IL-5 receptor, and (3) anti-IL-4 receptor α. There are also various potential future biologic therapeutics currently under investigation. Although there remains a paucity of data regarding prospective direct head-to-head comparisons of biologic therapeutics in asthma, there are some retrospective and indirect comparison data available.
    Conclusion: Precision medicine guides selection of biologic therapeutics along with shared decision-making. Biomarkers, although not comprehensive, allow approximations of likely mechanisms. Use of biomarkers, to include historical levels and trends, in addition to consideration of key clinical characteristics and comorbidities can greatly help guide biologic selection. Efficacy, safety, potential adverse effects, indications for other key comorbidities, and logistics should also be considered.
    MeSH term(s) Anti-Asthmatic Agents/pharmacology ; Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Biological Products/pharmacology ; Biological Products/therapeutic use ; Humans ; Precision Medicine ; Prospective Studies ; Retrospective Studies
    Chemical Substances Anti-Asthmatic Agents ; Biological Products
    Language English
    Publishing date 2022-01-31
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 1228189-x
    ISSN 1534-4436 ; 0003-4738 ; 1081-1206
    ISSN (online) 1534-4436
    ISSN 0003-4738 ; 1081-1206
    DOI 10.1016/j.anai.2022.01.024
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  8. Article ; Online: Hypereosinophilia after vaccination with the SARS-CoV-2 mRNA vaccines.

    Westreich, Aaron / Zelarney, Pearlanne / Wechsler, Michael E

    The journal of allergy and clinical immunology. In practice

    2023  Volume 11, Issue 5, Page(s) 1564–1566

    MeSH term(s) Humans ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Eosinophilia ; SARS-CoV-2 ; Vaccination/adverse effects
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2023-01-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2023.01.024
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  9. Article ; Online: Therapeutic Advances in Eosinophilic Granulomatosis with Polyangiitis.

    Bloom, Jessica L / Langford, Carol A / Wechsler, Michael E

    Rheumatic diseases clinics of North America

    2023  Volume 49, Issue 3, Page(s) 563–584

    Abstract: Eosinophilic granulomatosis with polyangiitis (EGPA) is an eosinophilic vasculitis that affects a variety of organ systems. Historically, glucocorticoids and a variety of other immunosuppressants were used to abrogate the inflammation and tissue injury ... ...

    Abstract Eosinophilic granulomatosis with polyangiitis (EGPA) is an eosinophilic vasculitis that affects a variety of organ systems. Historically, glucocorticoids and a variety of other immunosuppressants were used to abrogate the inflammation and tissue injury associated with EGPA. The management of EGPA has evolved greatly during the last decade with the development of novel targeted therapeutics that have resulted in significantly improved outcomes for these patients, with many more novel targeted therapies emerging.
    MeSH term(s) Humans ; Granulomatosis with Polyangiitis/drug therapy ; Churg-Strauss Syndrome/drug therapy ; Immunosuppressive Agents/therapeutic use ; Glucocorticoids/therapeutic use ; Inflammation ; Antibodies, Antineutrophil Cytoplasmic
    Chemical Substances Immunosuppressive Agents ; Glucocorticoids ; Antibodies, Antineutrophil Cytoplasmic
    Language English
    Publishing date 2023-04-28
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 92118-x
    ISSN 1558-3163 ; 0889-857X
    ISSN (online) 1558-3163
    ISSN 0889-857X
    DOI 10.1016/j.rdc.2023.03.006
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  10. Article ; Online: Current and Emerging Biologic Therapies for Asthma and COPD.

    Wechsler, Michael E

    Respiratory care

    2018  Volume 63, Issue 6, Page(s) 699–707

    Abstract: ... Targets for asthma and COPD include immunoglobulin E, interleukin 5, interleukin 4/interleukin 13, thymic ...

    Abstract Historical treatments for asthma and COPD have primarily focused on addressing the underlying inflammation and bronchoconstriction that result in air flow obstruction symptoms, including shortness of breath, cough, chest tightness, and mucus production. However, in the past several years, new research into the underlying pathophysiology of asthma and COPD has led to novel targeted therapies that address the underlying pathways that cause these obstructive disorders. As we have gained a better understanding of underlying disease mechanisms, we have begun to use biomarkers and endotypes to personalize our approach to therapy. Targets for asthma and COPD include immunoglobulin E, interleukin 5, interleukin 4/interleukin 13, thymic stromal lymphopoietin, interleukin 17, tyrosine kinases, and others. The new biologics are generally safe and well tolerated, and are bringing promise and hope of personalized therapy to patients with severe asthma.
    MeSH term(s) Asthma/therapy ; Biological Therapy/methods ; Humans ; Molecular Targeted Therapy/methods ; Pulmonary Disease, Chronic Obstructive/therapy
    Language English
    Publishing date 2018-05-21
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.06322
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